EHRs steal primary care doctors face time with patients, study finds

Primary care providers spend more time working with their electronic health record systems than they do looking at patients during visits, according to new research published in Family Medicine.

Researchers performed an observational study of family physician residents, attendings and ambulatory patients across 982 clinic visits, associated with 10 Residency Research Network of Texas (RRNeT) residencies from May to June 2015.

They found family providers spend about 18.6 minutes on clinical documentation in the EHR, but about 16.5 minutes on face-to-face interaction with patients. The length of time spent on a patient visit was more for the number of reasons for the visit, new patients, number of medications and the like.

The time breaks down to about 3 minutes working in the EHR before entering the exam room, 2 minutes working on the EHR in the room, 7.5 minutes of non-face time, or primarily EHR time, and another 6.9 minutes of EHR work outside of normal clinical hours.

Even worse, more 64 percent of visits involved EHR work outside of office hours. And 73 percent of the visits had physicians working with the EHR in the exam room.

“We found that family physicians spent more time in direct ambulatory patient care working in the EHR than they spent in face-to-face time with their patients,” the researchers wrote.

But even worse, the majority of providers worked through lunch, stayed late or took their work home with them to complete the EHR work from the day.

The researchers noted their results are similar to a recent study that found providers logged an average of 3.08 hours for office visits and 3.17 on the computer each day. However, the results contrast a recent U.K study that found providers spent 9.5 minutes with patients during a visit, compare to 3.3 minutes on the EHR.

“The UK results are consistent with observed consultation times across six countries in Europe in 2002 of 7.6 to 15.6 minutes total (overall mean, 10.7 minutes),” the researchers wrote. “Our results imply that U.S. family physicians spend more time working in the EHR than their European counterparts spend in the entire visit.”

These results aren’t surprising, as there have been multiple studies that gauged the number of time providers spend on EHR work, compared to time with the patient.

A 2017 study in the Annals of Family Medicine found providers spend nearly six hours on EHR data entry during an 11.4-hour workday. This extra time has often been criticized for contributing to physician burnout and a work-life imbalance.